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NPI Code Detail

MEDICARE: JANNIE MILLER MSW, CAP, ICADC

MEDICARE: JANNIE MILLER MSW, CAP, ICADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor0009624FL
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1972011385
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANNIE MILLER MSW, CAP, ICADC
Provider Business Mailing Address
First Line : 210 NE 24TH ST APT W412
Second Line :
City : WILTON MANORS
State : FL
Zip : 33305-1080
Country : US
Telephone Number : 954-529-6345
Fax Number :
Provider Business Practice Location Address
First Line : 325 SW 28TH ST
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33315-2612
Country : US
Telephone Number : 954-357-8251
Fax Number : 954-357-4898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2018
Last Update Date : 01/21/2025

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